SPSP 2013 Plenary session #4: Sergio Sismondo

SPSP 2013 Plenary session #4: Sergio Sismondo

Tweeted from the 4th biennial conference of the Society for Philosophy of Science in Practice in Toronto, Ontario, Canada, on June 29, 2013.

  1. Last plenary of conference: Sergio Sismondo, "Toward a political economy of epistemic things," starts in ~10 min #SPSP2013 #SPSP2013Toronto
  2. Knowledge as a quasi-substance (takes work, resources to make; requires infrastructure; moves w/ difficulty) #SPSP2013 #SPSP2013Toronto

  3. Political economies of knowledge (construct which might help us ask about the circumstances of production) #SPSP2013 #SPSP2013Toronto
  4. Very little talk in this conference about particular (local) scientific knowledge claims. Hmmm #SPSP2013 #SPSP2013Toronto
  5. Traditionally phil sci focused on epistemic norms; STS also thinks abt political norms of knowledge production #SPSP2013 #SPSP2013Toronto
  6. Production: contract research orgs (CROs) in pharmaceutical research (take 70-75% of industry's research funding) #SPSP2013 #SPSP2013Toronto
  7. @docfreeride and there's a whole raft of unexplored phil issues in contract pharma world, IMO
  8. 40K new trials annually, 3-6 million participants recruited/yr. ~50% of trials still in N. America #SPSP2013 #SPSP2013Toronto
  9. Also places that have "ready to recruit" and "treatment naive" subjects; ethical variability as another reason... #SPSP2013 #SPSP2013Toronto
  10. Local investment in trial resources can include ethical resources #SPSP2013 #SPSP2013Toronto
  11. "Can" or "should"? RT @docfreeride: Local investment in trial resources can include ethical resources #SPSP2013 #SPSP2013Toronto
  12. @drugmonkeyblog Apparently, actual cases where local investors are trying really hard to do it in reality.
  13. Another reason might be PR relations after adverse effects (can intended consumer see them easily?) #SPSP2013 #SPSP2013Toronto
  14. Another reason, @docfreeride, might be lax oversight, dodgy IRB and another Tuskeegee #SPSP2013Toronto
  15. Purposes of clinical trials: get drugs approved, "support, directly or indirectly, the marketing of our product" #SPSP2013 #SPSP2013Toronto
  16. "Volunteers" get obvious benefits (payment, access to medical care, etc.); not like volunteer from the audience #SPSP2013 #SPSP2013Toronto
  17. Lots of info in this talk from pharma conferences, documents, etc. #SPSP2013 #SPSP2013Toronto
  18. Publication plans (to turn data, info into med journal articles); treat knowledge as resource ... #SPSP2013 #SPSP2013Toronto
  19. ... to be efficiently developed, managed, deployed. Better read/cited than articles from indy ($) researchers #SPSP2013 #SPSP2013Toronto
  20. Foolish to leave production of paper to researcher! Ghostwriting #SPSP2013 #SPSP2013Toronto
  21. Has pharma learned *nothing*? MT @docfreeride: Foolish to leave production of paper to researcher! Ghostwriting #SPSP2013 #SPSP2013Toronto
  22. @jwoodgett @docfreeride they don't care that we know. That's what lobbyist money pays for
  23. You don't write it, but you give us your good name on the paper! (Be the sheet on the ghost, as it were) #SPSP2013 #SPSP2013Toronto
  24. I'm claiming that "sheet" metaphor as my own, by the way. (See this post, which was my first published usage of it, to establish my priority claim.)
  25. Multiplying papers. Involve lots of people early, get 8 papers from 1 pivotal program. #SPSP2013 #SPSP2013Toronto
  26. Sales rep: "Field reps are dying every day for more of your work"; it's what doctors are going to see. #SPSP2013 #SPSP2013Toronto
  27. Distribution & consumption: Pharma industry's key opinion leaders (KOLs). #SPSP2013 #SPSP2013Toronto
  28. KOL identification & advocacy development ~3 years before drug launch. KOLs' advocacy can be key to drug approval #SPSP2013 #SPSP2013Toronto
  29. Was Nemeroff mentioned?? RT @docfreeride: Distribution & consumption: Pharma industry's key opinion leaders (KOLs). #SPSP2013Toronto
  30. @drugmonkeyblog Not yet. The interview subjects have identities masked. Quoted promo lit has included named sources
  31. If you want to read about Charles B. Nemeroff, M.D., Ph.D., here's a place to start.
  32. Especially KOLs' claims about clinical need (sometimes overrules other considerations) #SPSP2013 #SPSP2013Toronto
  33. KOLs: highly respected medical experts in their domain who have greater (asymmetric) effect on their peers #SPSP2013 #SPSP2013Toronto
  34. Local KOLs: usually physicians; respected clinicians who give presentations #SPSP2013 #SPSP2013Toronto
  35. Track prescriptions before & after their presentations to measure investment (often better than sales rep) #SPSP2013 #SPSP2013Toronto
  36. Identical talks by KOL & sales rep: given by KOL, 2.5x more prescribing than given by sales rep #SPSP2013 #SPSP2013Toronto
  37. Local KOL given the slideset for their promotional talks. Not allowed to stray from slideset (legal reasons) #SPSP2013 #SPSP2013Toronto
  38. You don't want to end up with KOL illegally promoting the drug. Stay *just* on the right side of the line #SPSP2013 #SPSP2013Toronto
  39. Local KOLs have sales reps rounding up their audiences, their careers are built. May give 100s of talks annually #SPSP2013 #SPSP2013Toronto
  40. Local KOLs sometimes go on to become researchers, when they then become research KOLs. #SPSP2013 #SPSP2013Toronto
  41. One such research KOL's COIs: over a decade, a consultant for every drug that came on the market to treat bipolar #SPSP2013 #SPSP2013Toronto
  42. Reg. agency: "50 KOL advisory boards on same aspect of same product makes it look like you're not seeking advice" #SPSP2013 #SPSP2013Toronto
  43. Are research KOLs "managed"? There are individual KOL management plans, w/desired outcomes #SPSP2013 #SPSP2013Toronto
  44. So ... industry looks for alt language: OL engagement, managing experiences, building coalitions #SPSP2013 #SPSP2013Toronto
  45. Do KOLs communicate truths? See themselves as doing education, communicating scientific/clinical truths #SPSP2013 #SPSP2013Toronto
  46. Education, not being a shill (is how they see themselves). Might recognize the potential, if reflective #SPSP2013 #SPSP2013Toronto
  47. "I believe in these products! I wouldn't recommend them if it wasn't true..." #SPSP2013 #SPSP2013Toronto
  48. Hahaah. but yeah. RT @docfreeride: "I believe in these products! I wouldn't recommend them if it wasn't true..." #SPSP2013 #SPSP2013Toronto
  49. Since pharma industry manages KOLs, and KOLs have asymettric influence on their communities ... #SPSP2013 #SPSP2013Toronto
  50. ... pharma industry has asymmetric influence on those communities #SPSP2013 #SPSP2013Toronto
  51. Not many forces as strong at work to counter ghost managed science #SPSP2013 #SPSP2013Toronto
  52. Obviously, there are some issues about epistemic power here! #SPSP2013 #SPSP2013Toronto
  53. OMG, actually big pharma monopoly game that was swag at an industry conference! #SPSP2013 #SPSP2013Toronto
  54. @SabinaLeonelli : Striking how overt and public some of these processes these are. (Ghosts we can see!) #SPSP2013 #SPSP2013Toronto
  55. It's above-board enough that you can see it at a conference if you can pay the fee #SPSP2013 #SPSP2013Toronto
  56. ... but the talk is general, almost never about particular cases (plus KOLs don't notice selves being managed) #SPSP2013 #SPSP2013Toronto
  57. Ego stroking $$ = RT @docfreeride: (plus KOLs don't notice selves being managed) #SPSP2013 #SPSP2013Toronto
  58. Open access to data might create some countervailing forces. Not a panacea, though #SPSP2013 #SPSP2013Toronto
  59. Disclosure of stuff is almost always after the fact (so drugs have half patent life w/ ghost management at work) #SPSP2013 #SPSP2013Toronto
  60. Infiltration of this stuff into Continuing Education, tuning Bayesian priors of clinicians #SPSP2013 #SPSP2013Toronto
  61. Q: isn't it to be expected that for-profit companies will handle knowledge this way? #SPSP2013 #SPSP2013Toronto
  62. Q: Difference between KOL behavior and academic giving plenary talk at conference to promote his career? #SPSP2013 #SPSP2013Toronto
  63. General behavior might be predictable, but these particular strategies didn't emerge until 1970s,'80s #SPSP2013 #SPSP2013Toronto
  64. Different kinds of regulatory structures, patterns of behavior w/in physician communities *could* change things #SPSP2013 #SPSP2013Toronto
  65. Difference between academic talk & KOL behavior boil down to differences in power/power asymmetry #SPSP2013 #SPSP2013Toronto
  66. Tracking effects of initiatives is one of the things industry does #SPSP2013 #SPSP2013Toronto
  67. Young surgical fellows courted as potential KOLs complain that junkets aren't as good as the old days #SPSP2013 #SPSP2013Toronto
  68. Wah! RT @docfreeride: Young surgical fellows courted as potential KOLs complain that junkets aren't as good as the old days #SPSP2013
  69. Regulation is to thank. (If speaker fees aren't "fair market rate", it counts as a gift), but ... #SPSP2013 #SPSP2013Toronto
  70. Tighter regulations don't do much to address the movement of pharma's knowledge thru the system #SPSP2013 #SPSP2013Toronto
  71. "Corporate integrity agreements" struck by companies on verge or losing lawsuit; agreement w/gov #SPSP2013 #SPSP2013Toronto
  72. @docfreeride This is fascinating. (I used to work for a co that makes training materials for pharma sales reps so have seen some of this.)

Did you find this story interesting? Be the first to
or comment.

Liked!

Comments are off for this post